Provider Demographics
NPI:1700959756
Name:KOLIN-LIEBMAN, SUSAN RENEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:RENEE
Last Name:KOLIN-LIEBMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:185 MONTAGUE ST
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3608
Mailing Address - Country:US
Mailing Address - Phone:718-622-6741
Mailing Address - Fax:718-622-5125
Practice Address - Street 1:185 MONTAGUE ST
Practice Address - Street 2:8TH FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3608
Practice Address - Country:US
Practice Address - Phone:718-622-6741
Practice Address - Fax:718-622-5125
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0401561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics